维生素D在克罗恩病中的作用机制及外源性补充作用

Mechanism of action and exogenous supplementation of vitamin D in Crohn's disease

维生素D不仅可调节钙磷代谢,还具有免疫调节的作用。克罗恩病(Crohn's disease,CD)患者普遍缺乏维生素D。研究表明维生素D与CD等自身免疫性疾病有关,通过调节肠道免疫、修复肠黏膜屏障、抑制肠纤维化、增强对英夫利西单抗的应答、调节肠道菌群等途径改善CD患者的病情,促进患者的康复。外源性维生素D补充在提高血清维生素D水平的同时可以诱导疾病的缓解。但目前仅有少数随机双盲、安慰剂对照试验研究维生素D在CD中的治疗效果,有关维生素D最佳的补充形式、具体的补充剂量及需要维持的最佳血清浓度尚未明确。该文主要讨论维生素D在CD的作用机制及外源性维生素D补充对CD的有益作用。

Vitamin D can not only regulate calcium and phosphorus metabolism,but also exert an immunoregulatory effect.Vitamin D deficiency is common in patients with Crohn's disease(CD).Studies have shown that vitamin D is associated with CD and other autoimmune diseases and can improve the condition of patients with CD and promote their recovery by regulating intestinal immunity,repairing the intestinal mucosal barrier,inhibiting intestinal fibrosis,enhancing the response to infliximab,and regulating intestinal microbiota.Exogenous vitamin D supplementation can induce disease remission while increasing the serum level of vitamin D.However,only a few randomized,double-blind,and placebo-controlled trials have investigated the therapeutic effect of vitamin D in CD,and the optimal form of vitamin D supplementation,the specific dosage of vitamin D supplementation,and the optimal serum maintenance concentration of vitamin D remain to be clarified.This article mainly discusses the mechanism of action of vitamin D in CD and the beneficial effect of exogenous vitamin D supplementation on CD.